Induction on due date due to age...experiences appreciated!

[Shellywelly1973]

I will be 40 by the time Im 40 weeks.

I have an underactive thyroid that is now well managed. I was diagnosed only 4 days before i found out i was pregnant.

This is my 6 th baby all natural births. No problems. I did have a third degree tear with 1st dc but 4 Babys since either no problems or stitches. My last 2 Babys were born in a birth centre but i can't go there this time as the criteria is 5 or less births.

The consultant suggested i could use the MLU as long as there are no complications but Im thinking more of a homebirth if everything is ok.

Im now approaching 19 weeks & have an appointment with the consultant next week. Hospital policy is to induce mothers of 40 and above at 40 weeks. They also offer weekly monitoring from 37 weeks. I will have to use the labour ward if Im induced.

Are there benefits to this sort of 'management'? I will still be working so Im not sure how i would deal with the weekly monitoring as well as ante natel appointments. Where can i find statistics showing if there are any benefits to inducing at 40 weeks in mothers over 40?

This feels very strange to me so any experiences appreciated.

Anyone...?!?

Wow what fantastic care, the placenta starts to break down more quickly for 'older' ie over 40yr mums, and I expect they want to keep a check on you in case this starts a bit early especially coupled with your thyroid issue. I had dd at 44 and she was born by ecs at 38 weeks due to similar issues. Just be thankful that they are taking such good care of you.

There is an increase of stillbirth for older mothers that seems to be down to age on its own. The rate in any healthy woman is low, so doubling it is still a small number, less than 1%.

Age is only one factor that increases risk. Others are obesity, smoking, high blood pressure and diabetes. As a midwife it interests me that we don't routinely offer induction to the overweight and smokers too.

I think it depends on your views on interventions/induction. I would get them to talk through the risks of going over 40 weeks, including the relative risk (ie, risks for someone who is 40 relative to someone younger), and try to find out their understanding of the role of other factors (as mayhew says). Overall rates of stillbirth are very low... 1% at age 40 compared with 0.8 at age 35. The RCOG scientific impact report is here, might be an interesting read. It does say: "There remains a paucity of data specifically addressing the maternal and neonatal outcomes of older women induced at term compared to those expectantly managed." There is a large RCT going on currently--the 35/39 trial, that compares early induction with expectant management. The premise of every RCT is meant to be that we genuinely don't know which intervention is better...

The risks of them providing monitoring I guess are that the more you are monitored the more likely you are to end up having interventions.

I'm not over 35 but I am planning expectant management if I go 'post term', and I hope for a home birth too. I'll make sure I know what they are monitoring (e.g., blood flow, amniotic fluid levels) and why, ask for my bishops score, possibly have sweeps (if score is favourable), have some acupuncture etc.

Good luck

Thanks for the replies. Great link working title. My age is the only reason for offering monitoring &induction.

The thyroid is well managed. Im not overweight, don't smoke & healthy with no other health issues. My dc are spread over 24 years!

I think i will deal with this next January. Im open minded. I appreciate the medical help we have but i also feel pregnancy & childbirth are normal not medical events!

I was over 40 and went 11 days overdue and even then they were reluctant to induce me and I went into labour naturally. Not sue why you should have to accept induction just because of your age.

I think its probably just individual hospital policy rather then a national policy...